This invention relates generally to medical devices and, in particular, to a releasable, surgical clamp that is insertable through a surgical introducer sheath and into the cavity of a patient.
Temporary ligation of a tubular vessel such as a blood vessel is often required during a surgical procedure. This temporary ligation of a blood vessel is commonly performed using commercially available xe2x80x9cbulldogxe2x80x9d clamps and forceps. A bulldog clamp typically includes a pair of clamping jaws with a spring positioned between the proximal ends thereof . In use, the spring is compressed using forceps so that the distal ends of the clamping jaws are moved apart. Then the open jaws of the clamp are positioned over the vessel to be ligated. When the clamp is released from the forceps, the spring expands against the proximal ends of the clamping jaws for forcing the jaws together and gripping the vessel positioned therebetween.
A problem with these commercially available clamps is that they are impractical for use in minimally invasive surgical procedures such as laparoscopy, endoscopy, pelviscopy, and hysteroscopy, which utilize an access port with an inside diameter in the range of 5 to 10 mm. The bulldog clamps and forceps are simply too wide to fit through the port. As a result, the clamps cannot be introduced into a body cavity of a patient during a minimally invasive surgical procedure.
Another device for performing temporary ligation of a blood vessel is a V-shaped surgical clamp. The V-shaped clamp is positioned and compressed over a blood vessel using inserter forceps and removed therefrom using separate, remover forceps. A 0.5xe2x80x3 (12.7 mm) long V-shaped clamp is recommended for use when temporarily ligating a femoral artery through a 4xe2x80x3 (10.16 mm) long incision in the groin of a patient.
Again, a problem with the V-shaped clamp is that it is impractical for introduction with forceps through a minimally invasive access port. The clamp and inserter forceps together are simply too wide to fit through the access port. Another inconvenience of using the V-shaped surgical clamp is that the clamp requires separate forceps for the insertion and removal thereof.
The foregoing problems are solved and a technical advance is achieved in an illustrative releasable, surgical clamp that is insertable through a minimally invasive surgical introducer sheath and into the cavity of a patient. The surgical clamp comprises a continuous wire that is shaped for insertion through the surgical introducer sheath. The clamp includes opposing jaws having an open and a closed position. One of the jaws has a retainer that advantageously maintains the lateral displacement between the opposing jaws. Furthermore, the retainer minimizes, if not eliminates, the tendency for the surgical clamp to twist off a vessel due to a rotational torque that is created by the laterally displaced jaws. The longitudinally positioned retainer in the preferred embodiment creates a counterbalancing torque with the opposing jaw and stabilizes the clamp on the vessel. The surgical clamp also includes a resilient assembly that is also configured for insertion through the introducer sheath and extends to the opposing jaws and urges them to the closed position in the preferred embodiment.
The resilient assembly includes a torsion spring that urges the opposing jaws to an open or a closed position. The spring includes resilient arms that extend to the opposing jaws. In the preferred embodiment, the spring applies a load to the resilient arms to urge them apart. To translate this separating load, each of the resilient arms advantageously includes an angled distal portion that cross each other and urge the opposing jaws together to the closed position.
The opposing jaws advantageously include an atraumatic distal end to minimize, if not eliminate, trauma to tissue coming in contact therewith. Jaw extensions are attached to the opposing jaws to provide various contact and gripping configurations.
The releasable, surgical clamp of the present invention further includes a tubular, elongated containment member that is configured for insertion through the surgical introducer sheath. The tubular containment member has a hollow passage extending therein that is configured to receive the resilient assembly of the clamp. The elongated containment member also includes an engagement member that is positioned in the hollow passage and is extendable from the containment member to engage and urge the resilient assembly into the hollow passage.
The tubular containment member also includes a deflector positioned in the hollow passage and configured to engage the resilient member and to transition the opposing jaws between the open and closed positions. In the preferred embodiment, the deflector includes an annular recess in the tubular containment member and extends a projection or camming surface into the hollow passage of the containment member. In another aspect of the invention, the deflector includes a slotted sleeve positioned in the hollow passage through which the engagement member passes. To orient the releasable clamp with respect to the engagement member, opposing longitudinal recesses are positioned at the distal end of the containment member substantially perpendicular to the engagement member to receive and position the resilient arms of the clamp therein.